PDF(Pubmed)
Abstract：
BACKGROUND: Drug-induced mortality across the United States has continued to rise. To date, there are limited measures to evaluate patient preferences and priorities regarding substance use disorder (SUD) treatment, and many patients do not have access to evidence-based treatment options. Patients and their families seeking SUD treatment may begin their search for an SUD treatment facility online, where they can find information about individual facilities, as well as a summary of patient-generated web-based reviews via popular platforms such as Google or Yelp. Web-based reviews of health care facilities may reflect information about factors associated with positive or negative patient satisfaction. The association between patient satisfaction with SUD treatment and drug-induced mortality is not well understood.
OBJECTIVE: The objective of this study was to examine the association between online review content of SUD treatment facilities and drug-induced state mortality.
METHODS: A cross-sectional analysis of online reviews and ratings of Substance Abuse and Mental Health Services Administration (SAMHSA)-designated SUD treatment facilities listed between September 2005 and October 2021 was conducted. The primary outcomes were (1) mean online rating of SUD treatment facilities from 1 star (worst) to 5 stars (best) and (2) average drug-induced mortality rates from the Centers for Disease Control and Prevention (CDC) WONDER Database (2006-2019). Clusters of words with differential frequencies within reviews were identified. A 3-level linear model was used to estimate the association between online review ratings and drug-induced mortality.
RESULTS: A total of 589 SAMHSA-designated facilities (n=9597 reviews) were included in this study. Drug-induced mortality was compared with the average. Approximately half (24/47, 51%) of states had below average (\"low\") mortality rates (mean 13.40, SD 2.45 deaths per 100,000 people), and half (23/47, 49%) had above average (\"high\") drug-induced mortality rates (mean 21.92, SD 3.69 deaths per 100,000 people). The top 5 themes associated with low drug-induced mortality included detoxification and addiction rehabilitation services (r=0.26), gratitude for recovery (r=-0.25), thankful for treatment (r=-0.32), caring staff and amazing experience (r=-0.23), and individualized recovery programs (r=-0.20). The top 5 themes associated with high mortality were care from doctors or providers (r=0.24), rude and insensitive care (r=0.23), medication and prescriptions (r=0.22), front desk and reception experience (r=0.22), and dissatisfaction with communication (r=0.21). In the multilevel linear model, a state with a 10 deaths per 100,000 people increase in mortality was associated with a 0.30 lower average Yelp rating (P=.005).
CONCLUSIONS: Lower online ratings of SUD treatment facilities were associated with higher drug-induced mortality at the state level. Elements of patient experience may be associated with state-level mortality. Identified themes from online, organically derived patient content can inform efforts to improve high-quality and patient-centered SUD care.
OBJECTIVE: The objective of this study was to examine the association between online review content of SUD treatment facilities and drug-induced state mortality.
METHODS: A cross-sectional analysis of online reviews and ratings of Substance Abuse and Mental Health Services Administration (SAMHSA)-designated SUD treatment facilities listed between September 2005 and October 2021 was conducted. The primary outcomes were (1) mean online rating of SUD treatment facilities from 1 star (worst) to 5 stars (best) and (2) average drug-induced mortality rates from the Centers for Disease Control and Prevention (CDC) WONDER Database (2006-2019). Clusters of words with differential frequencies within reviews were identified. A 3-level linear model was used to estimate the association between online review ratings and drug-induced mortality.
RESULTS: A total of 589 SAMHSA-designated facilities (n=9597 reviews) were included in this study. Drug-induced mortality was compared with the average. Approximately half (24/47, 51%) of states had below average (\"low\") mortality rates (mean 13.40, SD 2.45 deaths per 100,000 people), and half (23/47, 49%) had above average (\"high\") drug-induced mortality rates (mean 21.92, SD 3.69 deaths per 100,000 people). The top 5 themes associated with low drug-induced mortality included detoxification and addiction rehabilitation services (r=0.26), gratitude for recovery (r=-0.25), thankful for treatment (r=-0.32), caring staff and amazing experience (r=-0.23), and individualized recovery programs (r=-0.20). The top 5 themes associated with high mortality were care from doctors or providers (r=0.24), rude and insensitive care (r=0.23), medication and prescriptions (r=0.22), front desk and reception experience (r=0.22), and dissatisfaction with communication (r=0.21). In the multilevel linear model, a state with a 10 deaths per 100,000 people increase in mortality was associated with a 0.30 lower average Yelp rating (P=.005).
CONCLUSIONS: Lower online ratings of SUD treatment facilities were associated with higher drug-induced mortality at the state level. Elements of patient experience may be associated with state-level mortality. Identified themes from online, organically derived patient content can inform efforts to improve high-quality and patient-centered SUD care.
摘要：
背景：整个美国的药物诱导死亡率持续上升。迄今为止,评估患者对药物使用障碍（SUD）治疗的偏好和优先事项的措施有限，许多患者无法获得循证治疗方案。寻求SUD治疗的患者及其家人可以开始在线搜索SUD治疗设施，在那里他们可以找到关于个别设施的信息，以及通过Google或Yelp等流行平台对患者生成的基于网络的评论的摘要。对卫生保健设施的基于网络的审查可以反映有关与积极或消极的患者满意度相关的因素的信息。患者对SUD治疗的满意度与药物引起的死亡率之间的关系尚不清楚。
目的：本研究的目的是检查SUD治疗设施的在线综述内容与药物诱导的状态死亡率之间的关系。
方法：对2005年9月至2021年10月期间列出的药物滥用和精神卫生服务管理局（SAMHSA）指定的SUD治疗设施的在线评论和评级进行了横断面分析。主要结果是（1）SUD治疗设施的平均在线评级从1星（最差）到5星（最佳），以及（2）疾病控制和预防中心（CDC）WONDER数据库（2006-2019）的平均药物诱导死亡率。确定了评论中频率不同的单词簇。使用3级线性模型来估计在线评论评级与药物引起的死亡率之间的关联。
结果：本研究共纳入589家SAMHSA指定的设施（n=9597条综述）。将药物诱导的死亡率与平均值进行比较。大约一半（24/47，51％）的州死亡率低于平均水平（“低”）（平均每100,000人死亡13.40，SD2.45），一半（23/47，49％）的药物诱导死亡率高于平均水平（“高”）（平均21.92，SD3.69每100,000人死亡）。与低药物死亡率相关的前5个主题包括戒毒和成瘾康复服务（r=0.26），对康复的感激(r=-0.25)，感谢治疗（r=-0.32），关怀的员工和惊人的经验（r=-0.23），和个性化恢复计划(r=-0.20)。与高死亡率相关的前5个主题是医生或提供者的护理（r=0.24），粗鲁和不敏感的护理(r=0.23)，药物和处方（r=0.22），前台和接待经验(r=0.22)，和对沟通的不满（r=0.21）。在多级线性模型中，每100,000人中有10人死亡的州死亡率增加与平均Yelp评分低0.30相关(P=.005)。
结论：在州一级，SUD治疗设施的较低在线评级与较高的药物诱导死亡率相关。患者体验要素可能与州级死亡率相关。从网上确定的主题，有机地得出的患者内容可以为改善高质量和以患者为中心的SUD护理提供信息。
目的：本研究的目的是检查SUD治疗设施的在线综述内容与药物诱导的状态死亡率之间的关系。
方法：对2005年9月至2021年10月期间列出的药物滥用和精神卫生服务管理局（SAMHSA）指定的SUD治疗设施的在线评论和评级进行了横断面分析。主要结果是（1）SUD治疗设施的平均在线评级从1星（最差）到5星（最佳），以及（2）疾病控制和预防中心（CDC）WONDER数据库（2006-2019）的平均药物诱导死亡率。确定了评论中频率不同的单词簇。使用3级线性模型来估计在线评论评级与药物引起的死亡率之间的关联。
结果：本研究共纳入589家SAMHSA指定的设施（n=9597条综述）。将药物诱导的死亡率与平均值进行比较。大约一半（24/47，51％）的州死亡率低于平均水平（“低”）（平均每100,000人死亡13.40，SD2.45），一半（23/47，49％）的药物诱导死亡率高于平均水平（“高”）（平均21.92，SD3.69每100,000人死亡）。与低药物死亡率相关的前5个主题包括戒毒和成瘾康复服务（r=0.26），对康复的感激(r=-0.25)，感谢治疗（r=-0.32），关怀的员工和惊人的经验（r=-0.23），和个性化恢复计划(r=-0.20)。与高死亡率相关的前5个主题是医生或提供者的护理（r=0.24），粗鲁和不敏感的护理(r=0.23)，药物和处方（r=0.22），前台和接待经验(r=0.22)，和对沟通的不满（r=0.21）。在多级线性模型中，每100,000人中有10人死亡的州死亡率增加与平均Yelp评分低0.30相关(P=.005)。
结论：在州一级，SUD治疗设施的较低在线评级与较高的药物诱导死亡率相关。患者体验要素可能与州级死亡率相关。从网上确定的主题，有机地得出的患者内容可以为改善高质量和以患者为中心的SUD护理提供信息。
